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Takagi A, Kusunoki Y, Ohigashi M, Osugi K, Inoue C, Inoue M, Tsunoda T, Kadoya M, Konishi K, Katsuno T, Koyama H. Association between continuous glucose monitoring-derived glycemic control indices and urinary biomarkers of diabetic kidney disease: Hyogo Diabetes Hypoglycemia Cognition Complications study. Acta Diabetol 2024; 61:413-423. [PMID: 38006524 DOI: 10.1007/s00592-023-02214-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 11/08/2023] [Indexed: 11/27/2023]
Abstract
AIMS Glomerular damage and proximal tubular damage play an important role in the pathogenesis of diabetic kidney disease. This study aimed to investigate the relationship between the urinary markers of proximal tubular injury, including urinary liver-type fatty acid-binding protein-to-creatinine ratio (uL-FABP/Cr) and urinary N-acetyl-β-D-glucosaminidase-to-creatinine ratio (uNAG/Cr), and glycemic control status. METHODS This cross-sectional study included 245 and 39 patients with type 2 diabetes mellitus (T2DM) and non-T2DM (NDM), respectively. The participants of this study were fitted with retrospective CGM, and glycemic control indices, such as time in range (TIR) and glycemia risk index (GRI), were calculated. RESULTS The results were presented as medians (interquartile ranges). The uL-FABP/Cr was significantly higher in the microalbuminuria than in the normo-albuminuria group [4.2 (2.7-7.1) and 2.2 (1.4-3.4) μg/gCr, respectively, P < 0.001], while the uNAG/Cr in the normo-albuminuria group [6.3 (4.5-10.1) U/gCr] was significantly higher than that in the NDM group [5.3 (3.8-6.3) U/gCr, P = 0.048] but significantly lower than that in the microalbuminuria group [9.2 (6.4-11.1) U/gCr, P = 0.004]. The multivariate logistic regression analysis indicated that CGM-derived TIR was significantly associated with the urinary albumin-to-creatinine ratio [uAlb/Cr, odds ratio (OR) 0.985, 95% confidence interval (CI) 0.971-0.998, P = 0.029] and uNAG/Cr (OR 0.973, 95% CI 0.957-0.989, P = 0.001) independent of renal function. GRI was similarly associated with uAlb/Cr and uNAG/Cr. CONCLUSION The findings of this study indicated that uNAG/Cr was elevated before albuminuria development and was associated with CGM-derived TIR and GRI.
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Affiliation(s)
- Ayako Takagi
- Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine, Hyogo Medical University, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Yoshiki Kusunoki
- Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine, Hyogo Medical University, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan.
| | - Mana Ohigashi
- Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine, Hyogo Medical University, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Keiko Osugi
- Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine, Hyogo Medical University, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Chikako Inoue
- Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine, Hyogo Medical University, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Maki Inoue
- Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine, Hyogo Medical University, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Taku Tsunoda
- Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine, Hyogo Medical University, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Manabu Kadoya
- Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine, Hyogo Medical University, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Kosuke Konishi
- Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine, Hyogo Medical University, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Tomoyuki Katsuno
- Department of Occupational Therapy, School of Rehabilitation, Hyogo Medical University, Nishinomiya, Hyogo, Japan
| | - Hidenori Koyama
- Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine, Hyogo Medical University, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
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Inoue C, Kusunoki Y, Ohigashi M, Osugi K, Kitajima K, Takagi A, Inoue M, Yagi C, Tsunoda T, Kakutani M, Kadoya M, Konishi K, Katsuno T, Koyama H. Association between brain imaging biomarkers and continuous glucose monitoring-derived glycemic control indices in Japanese patients with type 2 diabetes mellitus. BMJ Open Diabetes Res Care 2024; 12:e003744. [PMID: 38233078 PMCID: PMC10806821 DOI: 10.1136/bmjdrc-2023-003744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 12/19/2023] [Indexed: 01/19/2024] Open
Abstract
INTRODUCTION Although type 2 diabetes mellitus (T2DM) is associated with alterations in brain structure, the relationship between glycemic control indices and brain imaging markers remains unclear. This study aimed to investigate the association between continuous glucose monitoring (CGM)-derived glycemic control indices and brain imaging biomarkers assessed by MRI. RESEARCH DESIGN AND METHODS This cross-sectional study included 150 patients with T2DM. The severity of cerebral white matter lesions (WMLs) was assessed using MRI for deep and subcortical white matter and periventricular hyperintensities. The degree of medial temporal lobe atrophy (MTA) was assessed using voxel-based morphometry. Each participant wore a retrospective CGM for 14 consecutive days, and glycemic control indices, such as time in range (TIR) and glycemia risk index (GRI), were calculated. RESULTS The proportion of patients with severe WMLs showed a decreasing trend with increasing TIR (P for trend=0.006). The proportion of patients with severe WMLs showed an increasing trend with worsening GRI (P for trend=0.011). In contrast, no significant association was observed between the degree of MTA and CGM-derived glycemic control indices, including TIR (P for trend=0.325) and GRI (P for trend=0.447). CONCLUSIONS The findings of this study indicate that the severity of WMLs is associated with TIR and GRI, which are indices of the quality of glycemic control. TRIAL REGISTRATION NUMBER UMIN000032143.
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Affiliation(s)
- Chikako Inoue
- Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine, Hyogo Medical University, Nishinomiya, Hyogo, Japan
| | - Yoshiki Kusunoki
- Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine, Hyogo Medical University, Nishinomiya, Hyogo, Japan
| | - Mana Ohigashi
- Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine, Hyogo Medical University, Nishinomiya, Hyogo, Japan
| | - Keiko Osugi
- Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine, Hyogo Medical University, Nishinomiya, Hyogo, Japan
| | - Kazuhiro Kitajima
- Department of Radiology, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
| | - Ayako Takagi
- Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine, Hyogo Medical University, Nishinomiya, Hyogo, Japan
| | - Maki Inoue
- Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine, Hyogo Medical University, Nishinomiya, Hyogo, Japan
| | - Chisako Yagi
- Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine, Hyogo Medical University, Nishinomiya, Hyogo, Japan
| | - Taku Tsunoda
- Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine, Hyogo Medical University, Nishinomiya, Hyogo, Japan
| | - Miki Kakutani
- Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine, Hyogo Medical University, Nishinomiya, Hyogo, Japan
| | - Manabu Kadoya
- Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine, Hyogo Medical University, Nishinomiya, Hyogo, Japan
| | - Kosuke Konishi
- Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine, Hyogo Medical University, Nishinomiya, Hyogo, Japan
| | - Tomoyuki Katsuno
- Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine, Hyogo Medical University, Nishinomiya, Hyogo, Japan
| | - Hidenori Koyama
- Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine, Hyogo Medical University, Nishinomiya, Hyogo, Japan
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Osugi K, Kusunoki Y, Ohigashi M, Kusunoki K, Inoue C, Inoue M, Takagi A, Tsunoda T, Kadoya M, Konishi K, Katsuno T, Koyama H. Association between low-carbohydrate diets and continuous glucose monitoring-derived time in ranges. J Diabetes Investig 2023; 14:659-668. [PMID: 38078864 PMCID: PMC10119912 DOI: 10.1111/jdi.13999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 01/25/2023] [Accepted: 02/13/2023] [Indexed: 03/05/2023] Open
Abstract
AIMS Low-carbohydrate diets have become popular in the general community. The mutual relationship between the percentage of total energy intake from carbohydrates (CHO/E), glycemic control indices, and diabetes complications remains unclear. MATERIALS AND METHODS This cross-sectional study included 177 patients with type 2 diabetes mellitus who regularly visited outpatient clinics. In this study, dietary questionnaires were used to assess the intake ratio of the three macronutrients, and the low-carbohydrate-diet score was calculated. We investigated the association between the low-carbohydrate-diet score, continuous glucose monitoring (CGM)-derived short-term glycemic control indices, and diabetes complications in patients with type 2 diabetes mellitus. RESULTS The results are presented as medians (interquartile ranges) unless otherwise stated. Hemoglobin A1c was 7.1% (6.6-7.7%), CGM-derived time in range (TIR) was 75.3% (62.8-87.0%), body mass index (BMI) was 24.0 (22.1-26.3) kg/m2, and CHO/E was 49.8% (44.8-55.6%). BMI, triglycerides, and CGM-derived time above range decreased significantly with increasing low-carbohydrate-diet scores. However, no significant association was found between the low-carbohydrate-diet score and glycemic control indices, including TIR, mean amplitude of glycemic excursions, and vascular complications of type 2 diabetes mellitus. CONCLUSION Moderate-carbohydrate diets positively impact weight control and lipid metabolism but may have a limited effect on short-term glycemic variability in Japanese patients with type 2 diabetes mellitus.
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Affiliation(s)
- Keiko Osugi
- Department of Diabetes, Endocrinology and Clinical Immunology, School of MedicineHyogo Medical UniversityNishinomiyaHyogoJapan
| | - Yoshiki Kusunoki
- Department of Diabetes, Endocrinology and Clinical Immunology, School of MedicineHyogo Medical UniversityNishinomiyaHyogoJapan
- Kusunoki ClinicNeyagawa, OsakaJapan
| | - Mana Ohigashi
- Department of Diabetes, Endocrinology and Clinical Immunology, School of MedicineHyogo Medical UniversityNishinomiyaHyogoJapan
| | | | - Chikako Inoue
- Department of Diabetes, Endocrinology and Clinical Immunology, School of MedicineHyogo Medical UniversityNishinomiyaHyogoJapan
| | - Maki Inoue
- Department of Diabetes, Endocrinology and Clinical Immunology, School of MedicineHyogo Medical UniversityNishinomiyaHyogoJapan
| | - Ayako Takagi
- Department of Diabetes, Endocrinology and Clinical Immunology, School of MedicineHyogo Medical UniversityNishinomiyaHyogoJapan
| | - Taku Tsunoda
- Department of Diabetes, Endocrinology and Clinical Immunology, School of MedicineHyogo Medical UniversityNishinomiyaHyogoJapan
| | - Manabu Kadoya
- Department of Diabetes, Endocrinology and Clinical Immunology, School of MedicineHyogo Medical UniversityNishinomiyaHyogoJapan
| | - Kosuke Konishi
- Department of Diabetes, Endocrinology and Clinical Immunology, School of MedicineHyogo Medical UniversityNishinomiyaHyogoJapan
| | - Tomoyuki Katsuno
- Department of Occupational Therapy, School of RehabilitationHyogo Medical UniversityNishinomiyaHyogoJapan
| | - Hidenori Koyama
- Department of Diabetes, Endocrinology and Clinical Immunology, School of MedicineHyogo Medical UniversityNishinomiyaHyogoJapan
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Yagi C, Kusunoki Y, Tsunoda T, Murase T, Nakamura T, Osugi K, Ohigashi M, Morimoto A, Miyoshi A, Kakutani-Hatayama M, Kosaka-Hamamoto K, Kadoya M, Konishi K, Shoji T, Koyama H. Xanthine oxidoreductase activity is correlated with hepatic steatosis. Sci Rep 2022; 12:12282. [PMID: 35854080 PMCID: PMC9296494 DOI: 10.1038/s41598-022-16688-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 07/13/2022] [Indexed: 11/09/2022] Open
Abstract
The enzyme xanthine oxidoreductase (XOR) catalyzes the synthesis of uric acid (UA) from hypoxanthine and xanthine, which are products of purine metabolism starting from ribose-5-phosphate. Several studies suggested a relationship between hyperuricemia and hepatic steatosis; however, few previous studies have directly examined the relationship between XOR activity and hepatic steatosis. A total of 223 subjects with one or more cardiovascular risk factors were enrolled. The liver-to-spleen (L/S) ratio on computed tomography and the hepatic steatosis index (HSI) were used to assess hepatic steatosis. We used a newly developed highly sensitive assay based on [13C2, 15N2] xanthine and liquid chromatography/triple quadrupole mass spectrometry to measure plasma XOR activity. Subjects with the L/S ratio of < 1.1 and the HSI of < 36 had increased XOR activity and serum UA levels. Independent of insulin resistance and serum UA levels, multivariate logistic regression analysis revealed that plasma XOR activity was associated with the risk of hepatic steatosis as assessed by the L/S ratio and HSI. According to the findings of this study, plasma XOR activity is associated with hepatic steatosis independent of insulin resistance and serum UA levels.
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Affiliation(s)
- Chisako Yagi
- Department of Diabetes, Endocrinology and Clinical Immunology, Hyogo Medical University, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Yoshiki Kusunoki
- Department of Diabetes, Endocrinology and Clinical Immunology, Hyogo Medical University, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan.
| | - Taku Tsunoda
- Department of Diabetes, Endocrinology and Clinical Immunology, Hyogo Medical University, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Takayo Murase
- Radioisotope and Chemical Analysis Center, Laboratory Management Department, Sanwa Kagaku Kenkyusho, Nagoya, Japan
| | - Takashi Nakamura
- Radioisotope and Chemical Analysis Center, Laboratory Management Department, Sanwa Kagaku Kenkyusho, Nagoya, Japan
| | - Keiko Osugi
- Department of Diabetes, Endocrinology and Clinical Immunology, Hyogo Medical University, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Mana Ohigashi
- Department of Diabetes, Endocrinology and Clinical Immunology, Hyogo Medical University, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Akiko Morimoto
- Department of Diabetes, Endocrinology and Clinical Immunology, Hyogo Medical University, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Akio Miyoshi
- Department of Diabetes, Endocrinology and Clinical Immunology, Hyogo Medical University, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Miki Kakutani-Hatayama
- Department of Diabetes, Endocrinology and Clinical Immunology, Hyogo Medical University, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Kae Kosaka-Hamamoto
- Department of Diabetes, Endocrinology and Clinical Immunology, Hyogo Medical University, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Manabu Kadoya
- Department of Diabetes, Endocrinology and Clinical Immunology, Hyogo Medical University, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Kosuke Konishi
- Department of Diabetes, Endocrinology and Clinical Immunology, Hyogo Medical University, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Takuhito Shoji
- Department of Diabetes, Endocrinology and Clinical Immunology, Hyogo Medical University, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Hidenori Koyama
- Department of Diabetes, Endocrinology and Clinical Immunology, Hyogo Medical University, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
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Ohigashi M, Osugi K, Kusunoki Y, Washio K, Matsutani S, Tsunoda T, Matsuo T, Konishi K, Katsuno T, Namba M, Koyama H. Association of time in range with hemoglobin A1c, glycated albumin and 1,5-anhydro-d-glucitol. J Diabetes Investig 2021; 12:940-949. [PMID: 33058513 PMCID: PMC8169363 DOI: 10.1111/jdi.13437] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 10/03/2020] [Accepted: 10/07/2020] [Indexed: 12/25/2022] Open
Abstract
AIMS/INTRODUCTION Hemoglobin A1c (HbA1c), glycated albumin (GA) and 1,5-anhydro-d-glucitol (1,5-AG) are used as indicators of glycemic control, whereas continuous glucose monitoring (CGM) is used to assess daily glucose profiles. The aim of this study was to investigate the relationships between CGM metrics, such as time in range (TIR), and glycemic control indicators. MATERIALS AND METHODS We carried out retrospective CGM and blood tests on 189 outpatients with impaired glucose tolerance (n = 22), type 1 diabetes mellitus (n = 67) or type 2 diabetes mellitus (n = 100). RESULTS In type 1 diabetes mellitus and type 2 diabetes mellitus patients, HbA1c and GA were negatively correlated with TIR, whereas 1,5-AG was positively correlated with TIR. In type 1 diabetes mellitus patients, a TIR of 70% corresponded to HbA1c, GA and 1,5-AG of 6.9% (95% confidence interval [CI] 6.5-7.2%), 20.3% (95% CI 19.0-21.7%) and 6.0 µg/mL (95% CI 5.1-6.9 µg/mL), respectively. In type 2 diabetes mellitus patients, a TIR of 70% corresponded to HbA1c, GA and 1,5-AG of 7.1% (95% CI 7.0-7.3%), 19.3% (95% CI 18.7-19.9%) and 10.0 µg/mL (95% CI 9.0-11.0 µg/mL), respectively. TIR values corresponding to HbA1c levels of 7.0% were 56.1% (95% CI 52.3-59.8%) and 74.2% (95% CI 71.3-77.2%) in type 1 diabetes mellitus and type 2 diabetes mellitus patients, respectively. CONCLUSIONS The results of this study showed that the estimated HbA1c corresponding to a TIR of 70% was approximately 7.0% for both type 1 diabetes mellitus and type 2 diabetes mellitus patients, and that the estimated 1,5-AG calculated from the TIR of 70% might be different between type 1 diabetes mellitus and type 2 diabetes mellitus patients.
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Affiliation(s)
- Mana Ohigashi
- Department of Diabetes, Endocrinology and Clinical ImmunologyHyogo College of MedicineNishinomiyaHyogoJapan
| | - Keiko Osugi
- Department of Diabetes, Endocrinology and Clinical ImmunologyHyogo College of MedicineNishinomiyaHyogoJapan
| | - Yoshiki Kusunoki
- Department of Diabetes, Endocrinology and Clinical ImmunologyHyogo College of MedicineNishinomiyaHyogoJapan
| | - Kahori Washio
- Department of Diabetes, Endocrinology and Clinical ImmunologyHyogo College of MedicineNishinomiyaHyogoJapan
| | - Satoshi Matsutani
- Department of Diabetes, Endocrinology and Clinical ImmunologyHyogo College of MedicineNishinomiyaHyogoJapan
| | - Taku Tsunoda
- Department of Diabetes, Endocrinology and Clinical ImmunologyHyogo College of MedicineNishinomiyaHyogoJapan
| | - Toshihiro Matsuo
- Department of Diabetes, Endocrinology and Clinical ImmunologyHyogo College of MedicineNishinomiyaHyogoJapan
| | - Kosuke Konishi
- Department of Diabetes, Endocrinology and Clinical ImmunologyHyogo College of MedicineNishinomiyaHyogoJapan
| | - Tomoyuki Katsuno
- Department of Occupational TherapySchool of RehabilitationHyogo University of Health SciencesKobeHyogoJapan
| | - Mitsuyoshi Namba
- Department of Diabetes MellitusTakarazuka City HospitalTakarazukaHyogoJapan
| | - Hidenori Koyama
- Department of Diabetes, Endocrinology and Clinical ImmunologyHyogo College of MedicineNishinomiyaHyogoJapan
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Kuroda N, Kusunoki Y, Osugi K, Ohigashi M, Azuma D, Ikeda H, Makino S, Otsuka A, Tamada D, Watanabe N, Washio K, Tsunoda T, Matsuo T, Konishi K, Katsuno T, Koyama H. Relationships between time in range, glycemic variability including hypoglycemia and types of diabetes therapy in Japanese patients with type 2 diabetes mellitus: Hyogo Diabetes Hypoglycemia Cognition Complications study. J Diabetes Investig 2021; 12:244-253. [PMID: 32594655 PMCID: PMC7858127 DOI: 10.1111/jdi.13336] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 06/10/2020] [Accepted: 06/19/2020] [Indexed: 12/20/2022] Open
Abstract
AIMS/INTRODUCTION Continuous glucose monitoring (CGM) metrics, such as times in range (TIR) and time below range, have been shown to be useful as clinical targets that complement glycated hemoglobin (HbA1c) for patients with type 2 diabetes mellitus. We investigated the relationships between TIR, glycemic variability and patient characteristics in patients with type 2 diabetes mellitus. MATERIALS AND METHODS We carried out continuous glucose monitoring in 281 outpatients with type 2 diabetes mellitus who participated in a multicenter cohort (Hyogo Diabetes Hypoglycemia Cognition Complications) study. RESULTS The results are shown as the median (interquartile range). The age, disease duration and HbA1c were 68 years (62-71 years), 13 years (7-23 years) and 6.9% (6.5-7.5%), respectively. TIR and standard deviation obtained by continuous glucose monitoring worsened significantly with increasing disease duration. Multiple regression analyses showed that disease duration (standard partial regression coefficient, β = -0.160, P = 0.003), diabetic peripheral neuropathy (β = -0.106, P = 0.033) and urinary albumin excretion (β = -0.100, P = 0.043) were useful explanatory factors for TIR. In contrast, HbA1c (β = -0.398, P < 0.001) and the use of antidiabetic drugs potentially associated with severe hypoglycemia (β = 0.180, P = 0.028), such as sulfonylureas, glinides and insulin, were useful explanatory factors for time below range in the elderly patients with type 2 diabetes mellitus. CONCLUSIONS The results of this study suggest that disease duration and diabetic complications are associated with TIR deterioration. In addition, low HbA1c levels and the use of antidiabetic drugs potentially associated with severe hypoglycemia might worsen the time below range in the elderly.
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Affiliation(s)
- Norihiro Kuroda
- Division of Diabetes, Endocrinology and Clinical ImmunologyDepartment of Internal MedicineHyogo College of MedicineNishinomiyaJapan
| | - Yoshiki Kusunoki
- Division of Diabetes, Endocrinology and Clinical ImmunologyDepartment of Internal MedicineHyogo College of MedicineNishinomiyaJapan
| | - Keiko Osugi
- Division of Diabetes, Endocrinology and Clinical ImmunologyDepartment of Internal MedicineHyogo College of MedicineNishinomiyaJapan
| | - Mana Ohigashi
- Division of Diabetes, Endocrinology and Clinical ImmunologyDepartment of Internal MedicineHyogo College of MedicineNishinomiyaJapan
| | | | | | | | | | | | | | - Kahori Washio
- Division of Diabetes, Endocrinology and Clinical ImmunologyDepartment of Internal MedicineHyogo College of MedicineNishinomiyaJapan
| | - Taku Tsunoda
- Division of Diabetes, Endocrinology and Clinical ImmunologyDepartment of Internal MedicineHyogo College of MedicineNishinomiyaJapan
| | - Toshihiro Matsuo
- Division of Diabetes, Endocrinology and Clinical ImmunologyDepartment of Internal MedicineHyogo College of MedicineNishinomiyaJapan
| | - Kosuke Konishi
- Division of Diabetes, Endocrinology and Clinical ImmunologyDepartment of Internal MedicineHyogo College of MedicineNishinomiyaJapan
| | - Tomoyuki Katsuno
- School of RehabilitationDepartment of Occupational TherapyHyogo University of Health SciencesKobeJapan
| | - Hidenori Koyama
- Division of Diabetes, Endocrinology and Clinical ImmunologyDepartment of Internal MedicineHyogo College of MedicineNishinomiyaJapan
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Kitajima K, Abe K, Takeda M, Yoshikawa H, Ohigashi M, Osugi K, Koyama H, Yamakado K. Clinical impact of 11C-Pittsburgh compound-B positron emission tomography in addition to magnetic resonance imaging and single-photon emission computed tomography on diagnosis of mild cognitive impairment to Alzheimer's disease. Medicine (Baltimore) 2021; 100:e23969. [PMID: 33545981 PMCID: PMC7837835 DOI: 10.1097/md.0000000000023969] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 11/30/2020] [Indexed: 11/25/2022] Open
Abstract
This study aimed to evaluated the clinical impact of adding [11C] Pittsburgh compound-B (11C-PiB) PET for clinical diagnosis of mild cognitive impairment (MCI) to Alzheimer's disease (AD) dementia.Twenty six (mean age 78.5 ± 5.18 years, 21 females) AD (n = 7), amnestic MCI (n = 12), non-amnestic MCI (n = 3), vascular dementia, progressive supranuclear palsy (PSP) with frontotemporal dementia (FTD), FTD (n = 1 each), and normal (n = 1) patients underwent 11C-PiB-PET, MRI, and SPECT scanning. 11C-PiB-PET was compared with MRI and SPECT for clinical impact.11C-PiB-PET showed positivity in 6, 9, and 0 of the AD, amnestic MCI, and non-amnestic MCI patients, respectively, and 0 of those with another disease. Parahippocampal atrophy at VSASD was observed in 5 AD patients, 6 amnestic and PiB-positive MCI patients, 1 amnestic and PiB-negative MCI patient, and 1 vascular dementia patient. Parietal lobe hypoperfusion in SPECT findings was observed in 6, 4, and 2 of those, respectively, as well as 1 each of non-amnestic MCI, vascular dementia, and normal cases. Sensitivity/specificity/accuracy for selecting PiB-positive patients among the 15 MCI patients for 11C-PiB-PET were 100% (9/9)/100% (6/6)/100% (15/15), for VSRAD were 66.7% (6/9)/83.3% (5/6)/73.3% (11/15), and for SPECT were 44.4% (4/9)/50.0% (3/6)/46.7% (7/15), while those were 88.9% (8/9)/33.3% (2/6)/66.7% (10/15)/for combined VSRAD and SPECT. 11C-PiB-PET accuracy was significantly higher than that of SPECT.11PiB-PET alone may be useful for selecting patients who will progress from MCI to AD in the future, although follow-up study is necessary to clarify the outcome of MCI patients.
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Affiliation(s)
| | - Kazuo Abe
- Department of Neurology, Hyogo College of Medicine
| | | | | | - Mana Ohigashi
- Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism, Hyogo, Japan
| | - Keiko Osugi
- Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism, Hyogo, Japan
| | - Hidenori Koyama
- Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism, Hyogo, Japan
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Washio K, Kusunoki Y, Tsunoda T, Osugi K, Ohigashi M, Murase T, Nakamura T, Matsuo T, Konishi K, Katsuno T, Namba M, Koyama H. Xanthine oxidoreductase activity correlates with vascular endothelial dysfunction in patients with type 1 diabetes. Acta Diabetol 2020; 57:31-39. [PMID: 31093763 DOI: 10.1007/s00592-019-01362-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 05/03/2019] [Indexed: 01/22/2023]
Abstract
AIMS Xanthine oxidoreductase (XOR) is an enzyme regulating uric acid synthesis and generation of reactive oxygen species. Several studies suggested relationship between XOR and atherosclerotic diseases; however, few previous studies have directly examined the relationship between XOR and vascular endothelial dysfunction in patients with type 1 diabetes mellitus (T1DM). The aim of this study was to evaluate the relationship between XOR activity and vascular endothelial function in patients with T1DM. METHODS Seventy-one patients with T1DM participated in the study and underwent assessments, including plasma XOR activity and flow-mediated dilation (FMD), to measure vascular endothelial function. RESULTS The natural logarithm value of XOR activity (ln-XOR) was 3.03 ± 0.99 pmol/h/mL, and FMD was 5.5% ± 2.4%. FMD was inversely and significantly correlated with ln-XOR (correlation coefficient: r = - 0.396, P < 0.001), UA (r = - 0.252, P = 0.034), and asymmetric dimethylarginine (ADMA) (r = - 0.414, P < 0.001). ln-XOR showed positive correlation with HbA1c (r = 0.292, P = 0.013), ALT (r = 0.658, P < 0.001), and ADMA (r = 0.363, P = 0.002). Stepwise multiple regression analysis showed that ln-XOR (standard partial regression coefficient: β = - 0.254, P = 0.018) was an independent explanatory variable of FMD. CONCLUSIONS The results of this study showed for the first time that XOR activity is associated with glycemic control in patients with T1DM and that XOR activity is associated with vascular endothelial dysfunction.
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Affiliation(s)
- Kahori Washio
- Division of Diabetes, Endocrinology and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Yoshiki Kusunoki
- Division of Diabetes, Endocrinology and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan.
| | - Taku Tsunoda
- Division of Diabetes, Endocrinology and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Keiko Osugi
- Division of Diabetes, Endocrinology and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Mana Ohigashi
- Division of Diabetes, Endocrinology and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Takayo Murase
- Laboratory Management Department, Radioisotope and Chemical Analysis Center, Sanwa Kagaku Kenkyusho, Inabe, Mie, Japan
| | - Takashi Nakamura
- Laboratory Management Department, Radioisotope and Chemical Analysis Center, Sanwa Kagaku Kenkyusho, Inabe, Mie, Japan
| | - Toshihiro Matsuo
- Division of Diabetes, Endocrinology and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Kosuke Konishi
- Division of Diabetes, Endocrinology and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Tomoyuki Katsuno
- Department of Occupational Therapy, School of Rehabilitation, Hyogo University of Health Sciences, Kobe, Hyogo, Japan
| | - Mitsuyoshi Namba
- Division of Diabetes, Endocrinology and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Hidenori Koyama
- Division of Diabetes, Endocrinology and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
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Washio KW, Kusunoki Y, Murase T, Nakamura T, Osugi K, Ohigashi M, Sukenaga T, Ochi F, Matsuo T, Katsuno T, Moriwaki Y, Yamamoto T, Namba M, Koyama H. Xanthine oxidoreductase activity is correlated with insulin resistance and subclinical inflammation in young humans. Metabolism 2017; 70:51-56. [PMID: 28403945 DOI: 10.1016/j.metabol.2017.01.031] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 01/11/2017] [Accepted: 01/30/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND AIMS The enzyme xanthine oxidoreductase (XOR) catalyzes the formation of uric acid (UA) from hypoxanthine and xanthine, which in turn are products of purine metabolism starting from ribose-5-phosphate. Besides the synthesis of UA, basic research has suggested that XOR is involved in the regulation of reactive oxygen species, adipogenesis, and peroxisome proliferator-activated receptor-γ (PPAR-γ). XOR activity has shown to be much lower in humans than in rodents, which makes its accurate measurement difficult. Recently, a novel human plasma XOR activity assay has been established using a combination of liquid chromatography (LC) and triple quadrupole mass spectrometry (TQMS) to detect [13C2,15N2]UA using [13C2,15N2]xanthine as a substrate. Using this novel assay, we for the first time determine plasma XOR activity in humans, and evaluate its association with insulin resistance, high-sensitivity C-reactive protein (hsCRP) levels, and other parameters. METHODS Of the 29 volunteers who wished to participate in the study, 3 were excluded; of the remaining, 11 were female and 15 were male with a mean age of 25.9±3.3years. Blood samples were collected under fasting conditions in the early morning to measure XOR activity and other parameters. RESULTS The natural logarithmic value of XOR activity (ln-XOR) in plasma was 3.4±0.8pmol/h/mL. Ln-XOR had a positive correlation with UA and body mass index (BMI) and a negative correlation with quantitative insulin sensitivity check index (QUICKI) and adiponectin. In addition, ln-XOR had a positive correlation with hsCRP levels, which serves as a marker of chronic inflammation. CONCLUSIONS The present study has shown that XOR activity is correlated with serum UA levels in humans. Furthermore, even in young subjects, XOR activity is correlated with insulin resistance, BMI, and subclinical inflammation. Thus, XOR activity may be potentially involved in adiposity and subclinical inflammation in humans.
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Affiliation(s)
- Kahori Watanabe Washio
- Division of Diabetes, Endocrinology and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Yoshiki Kusunoki
- Division of Innovative Diabetes Treatment, Department of Internal Medicine, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan.
| | - Takayo Murase
- Radioisotope and Chemical Analysis Center, Laboratory Management Department, Sanwa Kagaku Kenkyusho Co. Ltd., 363 Shiosaki Hokusei Town Inabe, Mie 511-0406, Japan
| | - Takashi Nakamura
- Pharmacological Study Group, Pharmaceutical Research Laboratories, Sanwa Kagaku Kenkyusho Co. Ltd., 363 Shiosaki Hokusei Town Inabe, Mie 511-0406, Japan
| | - Keiko Osugi
- Division of Diabetes, Endocrinology and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Mana Ohigashi
- Division of Diabetes, Endocrinology and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Tadahiko Sukenaga
- Division of Diabetes, Endocrinology and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Fumihiro Ochi
- Division of Diabetes, Endocrinology and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Toshihiro Matsuo
- Division of Diabetes, Endocrinology and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Tomoyuki Katsuno
- Division of Diabetes, Endocrinology and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Yuji Moriwaki
- Division of Diabetes, Endocrinology and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Tetsuya Yamamoto
- Division of Diabetes, Endocrinology and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Mitsuyoshi Namba
- Division of Diabetes, Endocrinology and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Hidenori Koyama
- Division of Diabetes, Endocrinology and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
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Arai H, Osugi K, Ogihara S, Kohitsu K, Goto A. [Analysis of the contents of the medical record accompanying the patient at transfer to another ward. 3. Preparation of a standard form]. Kango 1982; 34:42-53. [PMID: 6921412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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Osugi K, Kataura S, Uomi M. [Group training of asthmatic children - introduction of sociometrics]. Kurinikaru Sutadi 1981; 2:104-12. [PMID: 7009998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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